Lichen Sclerosis and its male equivalent balanitis xerotica obliterans can be disabling conditions. It can cause disabling pain, burning, pruritis, and genital lesions. Lyme disease Borrelia burgdorferi have been detected in cases of this, so a recent study used Lyme disease treatments with startling effects.
Int J Dermatol. 2006 Sep;45(9):1104-6. Treatment of lichen sclerosus with antibiotics. Shelley WB, Shelley ED, Amurao CV.
- 6 men, 9 women
- IM Ceftriaxone sodium 1 g every 2 weeks worked best within weeks with striking relief of pain, burning and pruritis. They suggest 3 doses followed by once monthly on PRN basis (they did have cases on regular IM for up to 5 months)[Best regimen]. alternately, oral alternative cefadroxil monohydrate 500 mg b.i.d took 8 months of therapy.
- An alternate suggested treatment was “penicillin G benzathine suspension (long acting) 2.4 million units IM every 2 weeks for three doses, and then once a month on a p.r.n. basis”. This seemed to be followed by “penicillin V potassium 500 mg q.i.d., oral” – needing 5-12 months of treatment to gain full remission.
- Antibodies to Borrelia burgdorferi were negative, leaving the unsettling feeling that Lyme disease detection testing is inadequate.
Comment – Does demonstrate how painful Borrelia burgdorferi can be. Does point out the inadequacy of serology. Finding results linking bacteria, reminds me about how peptic ulcers became a Helicobacter disease and how so-called viral Pityriasis rosea responds to Erythromycin (divided doses X 2 weeks):
(though NOT Azithromycin). Also how seborrheic dermatitis turned out to be part Pityrosporum ovale infection. The most scary addition to this is the finding of Chlamydia in TMJ conditions:
There are multiple studies finding associated chlamydia antibodies, as well, leading to the diagnostic term of what is now called “inapparent infection” – presence of organisms but the joints are not hot. However, this might explain why in painful TMJ’s there are high levels of infection fighting Cytokinins which are known to be very irritating to nerves. One of the most interesting things I found about the TMJ/infection question is the finding of Chlamydia psittaci on occasion – bird chlamydia:
One polymerase amplification study found bird pet owners were at higher risk of that. I have come across bird pet owners with TMJ issues and wondered if they should be on antibiotics for an extended period to see if it helps.